IBHRE CEPS Final Exam – 200 Practice
Questions with Answers &
Rationales/IBHRE CEPS FINAL EXAM
WITH ALL QUESTIONS AND ANSWERS
This comprehensive practice exam is designed to help you prepare for the
IBHRE Certified Electrophysiology Specialist (CEPS) exam, consisting of
200 multiple-choice questions over 240 minutes (4 hours) across 4
sections, with each section lasting 60 minutes. A passing score of
approximately 70% is typically required.
The exam covers cardiac anatomy and physiology, pharmacology, clinical
electrophysiology, invasive procedures, and device therapy.
SECTION 1: CARDIAC ANATOMY, PHYSIOLOGY &
BASIC SCIENCE (Questions 1–40)
Question 1
Which structure is the primary site of the "slow pathway" responsible for
atrioventricular nodal reentrant tachycardia (AVNRT)?
A) Crista terminalis
B) Eustachian ridge
C) Inferoposterior extension of the AV node
D) Bundle of His
,Answer: C
Rationale: The slow pathway is located in the inferoposterior extension of
the atrioventricular node, near the coronary sinus os. The Bundle of His is
involved in rapid conduction, while the crista terminalis and eustachian
ridge are anatomical landmarks in the right atrium.
Question 2
The absolute refractory period of cardiac muscle corresponds to which part
of the surface ECG?
A) The P wave
B) The QRS complex
C) The T wave
D) The PR interval
Answer: C
Rationale: The absolute refractory period occurs during the upstroke and
plateau phases of the action potential. In the ECG, this corresponds to the
QRS complex and the peak of the T wave, while the T wave represents
ventricular repolarization.
Question 3
What is the primary neuroregulatory effect of the sympathetic nervous
system on the heart?
A) Decreases heart rate
B) Increases atrioventricular (AV) node conduction velocity
C) Decreases contractility
D) Increases the refractory period
Answer: B
,Rationale: Sympathetic stimulation increases the slope of phase 4
depolarization in pacemaker cells, leading to increased heart rate,
increased AV conduction velocity, and increased contractility.
Question 4
Which of the following is a characteristic of phase 0 of the cardiac action
potential in non-pacemaker cells?
A) Slow calcium influx
B) Potassium efflux
C) Fast sodium influx
D) Chloride influx
Answer: C
Rationale: Phase 0 is the rapid upstroke phase caused by the opening of
voltage-gated sodium channels and the rapid influx of sodium ions. This is
what gives the ventricular muscle cell its characteristic action potential.
Question 5
A patient's ECG shows a PR interval of 220 ms and a normal QRS complex.
What is the most likely diagnosis?
A) First-degree AV block
B) Type I second-degree AV block
C) Type II second-degree AV block
D) Third-degree AV block
Answer: A
Rationale: First-degree AV block is defined as a PR interval greater than 200
ms (usually around 220-240 ms) with 1:1 conduction of every P wave to the
ventricles, resulting in a normal QRS.
, Question 6
Which part of the coronary angiography system is most commonly used for
vascular access during an electrophysiology study?
A) Femoral artery
B) Femoral vein
C) Radial artery
D) Internal jugular vein
Answer: B
Rationale: The femoral vein is the preferred access site for diagnostic and
mapping catheters in an electrophysiology study.
Question 7
What is the sequence of electrical activation in a normally functioning
heart?
A) Ventricles → Bundle of His → AV node → SA node
B) SA node → AV node → Bundle of His → Purkinje fibers
C) AV node → SA node → Bundle of His → Purkinje fibers
D) Bundle of His → SA node → AV node → Ventricles
Answer: B
Rationale: The normal sequence starts with the SA node, followed by the AV
node, the Bundle of His, the bundle branches, and finally the Purkinje fibers.
Question 8
The SA node is richly innervated by which autonomic nervous system
components?
Questions with Answers &
Rationales/IBHRE CEPS FINAL EXAM
WITH ALL QUESTIONS AND ANSWERS
This comprehensive practice exam is designed to help you prepare for the
IBHRE Certified Electrophysiology Specialist (CEPS) exam, consisting of
200 multiple-choice questions over 240 minutes (4 hours) across 4
sections, with each section lasting 60 minutes. A passing score of
approximately 70% is typically required.
The exam covers cardiac anatomy and physiology, pharmacology, clinical
electrophysiology, invasive procedures, and device therapy.
SECTION 1: CARDIAC ANATOMY, PHYSIOLOGY &
BASIC SCIENCE (Questions 1–40)
Question 1
Which structure is the primary site of the "slow pathway" responsible for
atrioventricular nodal reentrant tachycardia (AVNRT)?
A) Crista terminalis
B) Eustachian ridge
C) Inferoposterior extension of the AV node
D) Bundle of His
,Answer: C
Rationale: The slow pathway is located in the inferoposterior extension of
the atrioventricular node, near the coronary sinus os. The Bundle of His is
involved in rapid conduction, while the crista terminalis and eustachian
ridge are anatomical landmarks in the right atrium.
Question 2
The absolute refractory period of cardiac muscle corresponds to which part
of the surface ECG?
A) The P wave
B) The QRS complex
C) The T wave
D) The PR interval
Answer: C
Rationale: The absolute refractory period occurs during the upstroke and
plateau phases of the action potential. In the ECG, this corresponds to the
QRS complex and the peak of the T wave, while the T wave represents
ventricular repolarization.
Question 3
What is the primary neuroregulatory effect of the sympathetic nervous
system on the heart?
A) Decreases heart rate
B) Increases atrioventricular (AV) node conduction velocity
C) Decreases contractility
D) Increases the refractory period
Answer: B
,Rationale: Sympathetic stimulation increases the slope of phase 4
depolarization in pacemaker cells, leading to increased heart rate,
increased AV conduction velocity, and increased contractility.
Question 4
Which of the following is a characteristic of phase 0 of the cardiac action
potential in non-pacemaker cells?
A) Slow calcium influx
B) Potassium efflux
C) Fast sodium influx
D) Chloride influx
Answer: C
Rationale: Phase 0 is the rapid upstroke phase caused by the opening of
voltage-gated sodium channels and the rapid influx of sodium ions. This is
what gives the ventricular muscle cell its characteristic action potential.
Question 5
A patient's ECG shows a PR interval of 220 ms and a normal QRS complex.
What is the most likely diagnosis?
A) First-degree AV block
B) Type I second-degree AV block
C) Type II second-degree AV block
D) Third-degree AV block
Answer: A
Rationale: First-degree AV block is defined as a PR interval greater than 200
ms (usually around 220-240 ms) with 1:1 conduction of every P wave to the
ventricles, resulting in a normal QRS.
, Question 6
Which part of the coronary angiography system is most commonly used for
vascular access during an electrophysiology study?
A) Femoral artery
B) Femoral vein
C) Radial artery
D) Internal jugular vein
Answer: B
Rationale: The femoral vein is the preferred access site for diagnostic and
mapping catheters in an electrophysiology study.
Question 7
What is the sequence of electrical activation in a normally functioning
heart?
A) Ventricles → Bundle of His → AV node → SA node
B) SA node → AV node → Bundle of His → Purkinje fibers
C) AV node → SA node → Bundle of His → Purkinje fibers
D) Bundle of His → SA node → AV node → Ventricles
Answer: B
Rationale: The normal sequence starts with the SA node, followed by the AV
node, the Bundle of His, the bundle branches, and finally the Purkinje fibers.
Question 8
The SA node is richly innervated by which autonomic nervous system
components?
